注意力缺陷多动障碍儿童事件相关电位检测及与智力的相关性
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福建省卫生计生中青年骨干人才培养项目(2017-ZQN-93);厦门市仙岳医院院内课题(XMXY2016-2)


Detection of event-related potentials and its correlation with intelligence in children with attention deficit hyperactivity disorder
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    摘要:

    目的 研究注意力缺陷多动障碍儿童(attention deficit hyperactivity disorder,ADHD)事件相 关电位(event related potential,ERP)的特征,研究 ERP 与多动指数及智力的相关性,探讨 ADHD 儿童的 认知功能。方法 选取 2019 年 6 月至 2020 年 12 月在厦门市仙岳医院门诊就诊的 61 例 ADHD 儿童作为 研究组,选取符合纳入及排除标准的 61 名健康儿童作为对照组,行 ERP 及韦氏智力检查,对两组儿童 照顾者行 Conners 父母问卷(PSQ)检查。结果 在靶刺激下,研究组前额区、中央区、顶叶区的 P3 潜伏 期明显长于对照组,差异均有统计学意义[(388.41±47.24)ms 比(372.89±34.75)ms、(395.31±55.18)ms 比(371.33±38.80)ms、(404.23±55.21)ms 比(381.54±38.93)ms,t=2.07、2.78、2.62,均P< 0.05);在靶刺 激下,两组在前额区、中央区、顶叶区的 P3 波幅比较,差异均有统计学意义[9.61(7.60,15.63)μV 比 13.52(10.04,16.90)μV、11.20(5.81,17.43)μV 比 13.49(9.22,16.54)μV、12.33(7.05,18.85)μV 比 14.74 (9.31,20.09)μV,Z=-2.77、-2.10、-2.06,均P<0.05)]。两组智力测验中的言语理解指数、知觉推理指数、 工作记忆指数、加工速度指数及总智商得分比较,研究组均低于对照组,差异有统计学意义[98.0(89.0, 103.5)比 99.0(95.5,107.0)、94.0(86.0,103.0)比 100.0(89.0,109.0)、85.0(75.0,97.0)比 91.0(87.0,97.0)、 83.0(77.0,95.0)比 92.0(80.5,99.0)、83.0(77.0,95.0)比 92.0(80.5,99.0),Z=-2.10、-2.54、-3.70、-3.33、 -2.86,均P< 0.05];研究组的多动指数评分高于对照组[1.80(1.60,2.10)比 0.80(0.65,1.15),Z=-9.54,P< 0.05]。相关分析结果显示,研究组的 P3 潜伏期与工作记忆指数(WMI)和加工速度指数(PSI)呈负相关 (r=-0.29、-0.26,P< 0.05),N2P3 峰值与 PSI 呈正相关(r=0.30,P< 0.05)。结论 ADHD 儿童存在一定程 度的认知功能障碍,ERP 能测量 ADHD 患儿的认知功能状况,ERP 和韦氏智力联合使用有助于客观、全 面地评价 ADHD。

    Abstract:

    Objective To study the characteristics of event related potential (ERP) in children with attention deficit hyperactivity disorder (ADHD) and the correlation between ERP and hyperactivity index and intelligence, and to explore the cognitive function of children with ADHD. Methods From June 2019 to December 2020, 61 children with ADHD treated in the outpatient department of Xiamen Xian Yue Hospital were selected as the study group, and 61 healthy children who met the inclusion and exclusion criteria were selected as the control group. ERP and Wechsler intelligence test were performed on children, and Conners Parent Symptom Qeustionnaire (PSQ) was performed on two groups of child caregivers. Results Under target stimulation, the P3 latency of prefrontal region, central region and parietal lobe in the study group was significantly longer than that in the control group, and the difference was statistically significant [(388.41±47.24) ms vs (372.89±34.75) ms, (395.31±55.18) ms vs (371.33±38.80) ms, (404.23±55.21) ms vs (381.54±38.93) ms; t=2.07, 2.78, 2.62; P < 0.05]. Under target stimulation, there were significant differences in P3 amplitude in prefrontal region, central region and parietal lobe between the two groups [9.61 (7.60, 15.63)μV vs 13.52 (10.04, 16.90)μV, 11.20 (5.81, 17.43)μV vs 13.49 (9.22, 16.54)μV, 12.33 (7.05, 18.85)μV vs 14.74 (9.31, 20.09)μV; Z=-2.77, -2.10, -2.06; P < 0.05]. There were significant differences in speech comprehension index, perceptual reasoning index, working memory index, processing speed index and total IQ scores between the two groups [98.0 (89.0, 103.5) vs 99.0 (95.5, 107.0), 94.0 (86.0, 103.0) vs 100.0 (89.0, 109.0), 85.0 (75.0, 97.0) vs 91.0 (87.0, 97.0), 83.0 (77.0, 95.0) vs 92.0 (80.5, 99.0), 83.0 (77.0, 95.0) vs 92.0 (80.5, 99.0); Z=-2.10, -2.54, -3.70, -3.33, -2.86; P< 0.05]. The hyperactivity index score of the study group was higher than that of the control group [1.80 (1.60, 2.10) vs 0.80 (0.65, 1.15); Z=9.54; P< 0.05]. Correlation analysis results showed that the latency of P3 was negatively correlated with working memory index (WMI) and processing speed index (PSI) (r=-0.29, -0.26, P < 0.05). The peak-to-peak value of N2P3 was positively correlated with PSI (r=0.30, P < 0.05). Conclusions ADHD children have a certain degree of cognitive dysfunction, ERP can measure the cognitive function of ADHD children, and the combined use of ERP and Wechsler intelligence is conducive to an objective and comprehensive evaluation of ADHD.

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李宗磊 王文强 吴为阁 李玉妹 钟训华.注意力缺陷多动障碍儿童事件相关电位检测及与智力的相关性[J].神经疾病与精神卫生,2021,21(10):
DOI :10.3969/j. issn.1009-6574.2021.10.004.

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  • 在线发布日期: 2021-11-23